Background: Thyroid dysfunction may be a hidden risk factor in children with both cyanotic and acyanotic congenital heart disease. Left and right ventricular cardiac functions may be impaired in children diagnosed with subclinical hypothyroidism (SCH). While this association with cyanotic heart disease is well documented, this issue remains underexplored in cases of acyanotic heart disease.
Objective: To estimate the prevalence of SCH and identify relevant clinical risk factors among pediatric patients with acyanotic heart disease.
Methods: In this hospital-based cross-sectional study, investigators evaluated 51 children aged 1 month to 11 years with echocardiographically confirmed acyanotic congenital heart disease. They measured serum TSH and free T4 (FT4) and defined SCH as elevated TSH with normal FT4. Standardized clinical history, medication review, physical examination, anthropometric assessment, and echocardiographic characterization of CHD type and severity were performed. Multiple risk factors were tested to identify those associated with this clinical problem.
Results: SCH affected 19.6% of the cohort. with a mean age of 1.05 ± 1.78 years. Ventricular septal defect was the most common diagnosis (37%). A younger age showed a notable link (P = 0.016). During logistic regression analysis, female sex had an odds ratio of 2.89, age <1 year had an odds ratio of 2.83, VSD diagnosis had an odds ratio of 0.67, and hemoglobin <11 g/dL had an odds ratio of 1.16, respectively. Thus, they were possible exploratory clinical predictors for thyroid dysfunction.
Conclusion: Young children with acyanotic congenital heart disease show a prevalence of subclinical hypothyroidism, with age being the most important factor according to the study. While ventricular septal defects are indeed the most prevalent congenital anomaly in non-cyanotic heart conditions, we did not observe any particular other heart defect to independently predict thyroid dysfunction, suggesting that the relationship ma y be systemic rather than tied to a particular cardiac structure. These results indicate the possible advantages of early thyroid tests for these newborns with a cyanotic heart disease.